Physiotherapy

Editorial Board

2010-03-01

Chest physiotherapy for patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease (COPD): a systematic review

Clarice Y. Tang, Nicholas F. Taylor, Felicity C. Blackstock — 2010-03-01

Abstract: Objectives: To examine the effectiveness of chest physiotherapy for patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease (COPD).Data source: CINAHL, MEDLINE, Embase, Cochrane, Expanded Academic Index, Clinical Evidence, PEDro, Pubmed, Web of Knowledge and Proquest were searched from the earliest available time to September 2007, using the key elements of COPD, acute exacerbation and chest physiotherapy interventions.Review methods: To be included, trials had to investigate patients during admission to hospital with an acute exacerbation of COPD, and to evaluate at least one physiotherapy intervention. Two reviewers independently applied the inclusion criteria, and assessed trial quality using the PEDro scale. Results were expressed as standardised mean differences and analysed qualitatively with a best-evidence synthesis.Results: Thirteen trials were identified. There was moderate evidence that intermittent positive pressure ventilation and positive expiratory pressure were effective in improving sputum expectoration. In addition, there was moderate evidence that walking programmes led to benefits in arterial blood gases, lung function, dyspnoea and quality of life. No evidence was found supporting the use of any other chest physiotherapy techniques to change lung function, arterial blood gases, perceived level of dyspnoea or quality of life.Conclusions: Chest physiotherapy techniques such as intermittent positive pressure ventilation and positive expiratory pressure may benefit patients with COPD requiring assistance with sputum clearance, while walking programmes may have wider benefits for patients admitted with an exacerbation of COPD. Chest physiotherapy techniques other than percussion are safe for administration to this patient population.

Effects of an acute hamstring stretch in people with and without osteoarthritis of the knee

Duncan A. Reid, Peter J. McNair — 2009-09-07

Abstract: Objective: To compare the effects of an acute stretching intervention on knee extension range of motion, passive resistive torque and stiffness in subjects with osteoarthritis of the knee, and to compare these variables with subjects without osteoarthritis.Design: Cross-sectional experimental study.Setting: Human performance laboratory.Participants: A total of 55 participants were recruited: 28 subjects (males and females) with osteoarthritis of the knee joint and 27 subjects of a similar age without osteoarthritis of the knee joint.Intervention: Using the Kincom dynamometer, three 60-second stretches with 60seconds of rest between stretches were applied to the hamstring muscle group.Main outcome measures: Peak knee extension range of motion, peak passive torque and stiffness in the final 10% of knee extension range of motion.Results: A significant (P<0.05) increase in knee extension range of motion, peak passive torque and stiffness was observed in both groups. For knee extension range of motion, the mean difference for the osteoarthritis group and non-osteoarthritis group was 4.9 degrees [95% confidence interval (CI) 0.9 to 8.5] and 4.4 degrees (95% CI 1.8 to 6.8), respectively. For peak passive torque, the mean difference in the osteoarthritis group and the non-osteoarthritis group was 4.4Nm (95% CI 0.8 to 6.9) and 1.0Nm (95% CI −1.4 to 3.5), respectively. For stiffness in the final 10% of knee extension range of motion, the mean difference for the osteoarthritis group and the non-osteoarthritis group was 0.19Nm/degree (95% CI 0.08 to 0.3) and 0.04Nm/degree (95% CI −0.05 to 0.1), respectively. Stiffness in the final 10% of knee extension range of motion was significantly higher in the osteoarthritis group compared with the non-osteoarthritis group after stretching.Conclusions: Elderly individuals with and without osteoarthritis of the knee are able to demonstrate immediate beneficial adaptations to a stretching intervention. This is important as stretching is often used in preparation for exercise programmes.

Does amplitude-modulated frequency have a role in the hypoalgesic response of interferential current on pressure pain sensitivity in healthy subjects? A randomised crossover study

Jorge Fuentes C, Susan Armijo-Olivo, David J. Magee, Douglas Gross — 2009-09-07

Abstract: Objective: To investigate the hypoalgesic effect of amplitude-modulated frequency during interferential current therapy using an experimentally induced mechanical pain model in normal subjects. This study examined pain pressure sensitivities achieved when the amplitude-modulated frequency parameter was present (100Hz) and absent (0Hz).Design: Randomised controlled crossover trial with repeated measures.Setting: University research laboratory.Participants: Forty-six healthy volunteers (23 males, 23 females).Interventions: Two interferential therapy protocols (with and without amplitude-modulated frequencies) were applied to the lumbar area on two different days.Main outcome measures: Pressure pain thresholds over the lumbar area were measured before, during and after application of the interferential therapy protocols.Results: A three-way analysis of variance with repeated measures failed to show any statistically significant difference between the two protocols in modifying pressure pain threshold values (mean difference 0.017kg/cm2, 95% confidence interval −0.384 to 0.350, P=0.93). Statistically significant differences were identified (P<0.001) between measurements, indicating a comparable decrease in pain sensitivity in both groups. However, the increase in pressure pain thresholds (0.76kg/cm2) failed to reach a level of clinical importance.Conclusions: The addition of an amplitude-modulated frequency parameter to interferential therapy did not influence mechanical pain sensitivity in healthy subjects. Amplitude-modulated frequency is therefore unlikely to have a physiological hypoalgesic effect.

A comparison of the perceptions and aspirations of third-year physiotherapy students trained in three educational settings in Poland

2009-10-23

Abstract: Objectives: In Poland, physiotherapy is offered at three types of school: medical universities, universities of physical education, and schools that do not specialise in either the medical sciences or physical education. This study explored the knowledge of students who were completing their physiotherapy studies about working in Poland and other countries of the European Union (EU), and about their vocational plans. Students were asked, through self-assessment, about aspects of the professional skills they had gained.Design: Quantitative questionnaire-based study of students in three university settings.Setting: Eleven university-level schools in Poland offering studies in physiotherapy and representing three orientations: medical sciences (MS), physical education (PE) and other universities (OU).Participants: The study sample comprised of 954 third-year Bachelor programme students.Results: The differences in university profiles did not influence the vocational plans of the students, with more than 70% (668/954) declaring that they would look for work outside Poland: 76% (725/954) in the UK and 69% (658/954) in Germany. Most students stated that finding work as a physiotherapist is difficult in Poland (686/954,72%) and easy in other EU countries (763/954, 80%). Differences in university profiles had an effect on the students’ assessments of their professional skills, as students from universities without a long-standing tradition of training in physiotherapy declared that they were less well prepared to work as physiotherapists; the difference was statistically significant for 12 of the 16 domains examined (P<0.05).Conclusions: In the light of these results, an increased influx of Polish physiotherapists, trained according to European standards, into EU countries, especially the UK and Germany, is to be expected in the near future. The physiotherapists will predominantly be graduates of medical and sports-oriented state universities. It appears advisable to launch, under the auspices of an EU programme, an integrated employment information system for physiotherapists that would offer updated information on current demand in individual EU countries.

The National Clinical Audit of Falls and Bone Health—secondary prevention of falls and fractures: a physiotherapy perspective

2009-09-04

Abstract: Objective: To establish current physiotherapy practice in the secondary management of falls and fragility fractures compared with national guidance.Design: Web-based national clinical audit.Participants: Acute trusts (n=157) and primary care trusts (n=146) in England, Wales and Northern Ireland.Results: Data were collected on 5642 patients with non-hip fragility fractures and 3184 patients with a hip fracture. Those patients who were bedbound or who declined assessment or rehabilitation were excluded from the analysis. Results indicate that of those with non-hip fractures, 28% received a gait and balance assessment, 22% participated in an exercise programme, and 3% were shown how to get up from the floor. For those with a hip fracture, the results were 68%, 44% and 7%, respectively.Conclusions: Physiotherapists have a significant role to play in the secondary prevention of falls and fractures. However, along with managers and professional bodies, more must be done to ensure that clinical practice reflects the evidence base and professional standards.

Attitudes of Flemish physiotherapy students towards mental health and psychiatry

Michel Probst, Jos Peuskens — 2009-10-26

Abstract: Objectives: In general, psychiatry is not very popular among healthcare providers, although no information is available concerning the attitudes of physiotherapy students towards mental heath. This study examined the attitudes of physiotherapy students towards psychiatry considering the subject's gender, previous experience with psychiatry and the impact of a specific course.Method: This experimental study compared the attitudes of physiotherapy students (n=219) with those of students without a biomedical background (n=112) towards psychiatry. All students were between 17 and 28 years of age, and completed an established international questionnaire entitled ‘Attitudes Towards Psychiatry’. Within the group of physiotherapy students, the effect of a 65-hour course on psychiatric rehabilitation on their attitudes was evaluated.Results: Attitudes towards psychiatry were moderately positive [mean (SD) 103.3 (9.9)]. There was a small but significant difference between physiotherapy students and non-medical students (Cohen's d=0.31). Female students had a more positive attitude towards psychiatry than their male peers (Cohen's d=0.44). Prior experience with mental illness was associated with more positive attitudes (Cohen's d=0.68). Attitudes increased in positivity after completion of a psychiatry course (Cohen's d=0.72).Discussion and conclusion: To ensure basic physiotherapeutic treatment for the mentally ill, physiotherapy education should aim to promote positive attitudes towards mental illness as well as psychiatry. High-quality courses and personal interaction with patients are the best strategies to achieve this goal.

The experience of spinal cord injury: using Frank's narrative types to enhance physiotherapy undergraduates’ understanding

A. Soundy, B. Smith, F. Cressy, L. Webb — 2009-08-03

Abstract: Objectives: To consider physiotherapy students’ responses to three illness narratives common in rugby players who have suffered a spinal cord injury (SCI).Design: A narrative vignette was provided to first and third year students reading for a Batchelor of Science degree in physiotherapy.Setting: A university in the West Midlands during a year cohort meeting.Participants: Seventy-seven first year students and 45 third year students took part in the study. All students were attending the university at the time of the study. None of the first year students had completed any clinical placement hours, and all of the third year students had completed the required number of clinical hours for a physiotherapy degree.Main outcome measures: The narrative vignette consisted of nine questions relating to the vignette. Thematic content analysis was applied to the results.Results: The role of experience appeared to influence students’ responses. The third year students’ reactions to each narrative appeared more consistent and unified as a medical voice. This appeared to support their preference for an ideal type of story and patient. Problems with each narrative were identified, although often not critiqued.Conclusions: Students need more time to consider different illness narratives in order to accept and understand them.

Reliability of scapular positioning measurement procedure using the Palpation Meter (PALM)

2009-09-03

Abstract: Background and objectives: Observation and measurement of the static position of the scapula is important for investigating both shoulder and neck pathology. Measurement of scapular position is complex and lacks a clinically useful instrument. The objective of this study was to investigate the reliability of the Palpation Meter (PALM) for measuring scapular position when the glenohumeral joint is held in various positions.Methods: Thirty normal subjects were recruited for a test–retest reliability study. Three raters conducted measurements on two different occasions to estimate intra- and inter-rater reliability. The scapular positions evaluated in this study were: (1) the horizontal distance between the scapula and the spine in the scapular resting position and during elevation of the arm in the scapular plane; and (2) the vertical distance between C7 and the acromion (C7–A). Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and Bland and Altman limits of agreement were calculated.Results: Reliability values for measurements of the horizontal distance between the scapula and the spine were generally good for both intra-rater (ICC 0.81 to 0.89; SEM 0.56 to 1.17cm) and inter-rater (ICC 0.67 to 0.89; SEM 0.59 to 0.98cm) evaluation. Reliability values of measurement of depression of the acromion were also good for both intra-rater (ICC 0.72 to 0.78; SEM 0.66 to 0.79) and inter-rater (ICC 0.76; SEM 0.64) evaluation. No systematic bias was observed with Bland and Altman analysis.Conclusions: The PALM is a reliable tool for the measurement of scapular positioning in a healthy sample. Future studies should be conducted to further investigate the clinometric properties of the PALM in patient populations before its clinical usefulness for measuring scapular position can be established.

Pulmonary rehabilitation for chronic obstructive pulmonary disease: a pilot study evaluating a once-weekly versus twice-weekly supervised programme

Fiona Liddell, Janet Webber — 2009-07-13

Abstract: Objectives: To compare the effectiveness of a once-weekly supervised pulmonary rehabilitation programme with a standard twice-weekly format.Design: Randomised trial of equivalency.Setting: Pulmonary rehabilitation service of a primary care trust delivered at two physiotherapy outpatient departments.Participants: Thirty patients with chronic obstructive pulmonary disease.Outcome measures: Primary outcomes were the Incremental Shuttle Walking Test (ISWT), Endurance Shuttle Walking Test (ESWT) and St George's Respiratory Questionnaire (SGRQ), assessed at baseline and at completion of the supervised programme. Secondary outcomes were home-exercise activity, attendance levels and patient satisfaction with the programme.Interventions: The once-weekly group (n=15) received one supervised rehabilitation session per week, and the twice-weekly group (n=15) received two sessions per week, both for 8 weeks, together with a home-exercise plan.Results: After pulmonary rehabilitation, the groups showed similar improvements in exercise tolerance (median values: ISWT once-weekly 60metres, twice-weekly 50metres; ESWT once-weekly 226seconds, twice-weekly 109seconds). However, for health-related quality-of-life, the once-weekly group's score did not change (SGRQ 0), whereas an improvement was seen for the twice-weekly group (SGRQ 3.7). The number of home-exercise sessions and attendance levels were similar between the groups. Patient satisfaction with both formats was high and almost identical between the groups.Conclusions: This pilot provides data to inform a larger study and shows that the methodology is feasible. The findings suggest that once-weekly supervision may be capable of producing equivalent improvements in exercise tolerance as a twice-weekly programme, but the health-related quality-of-life outcome appeared to be poorer for once-weekly supervision.

Qualitative research highlights the challenges of developing new roles for physiotherapy in the optimisation of activity following stroke

2009-12-25

We read with interest the recently published discussion paper by Morris and Williams on the potential future roles for physiotherapists in facilitating participation in physical activities amongst people with stroke . This was a timely and interesting paper which highlighted the current lack of physical activity in this population, and argued that physiotherapists are ideally placed to support engagement with long-term activity participation before and after rehabilitation discharge.

Letter to the Editor

Pauline M. Pope — 2009-12-25

As the main author of the textbook, ‘Severe and Complex Neurological Disability. Management of the Physical Condition’ reviewed recently , I felt it was, on the whole, a very fair review. However, I take issue with the reviewer on one point.

Michael A. Hunt — 2010-01-13

There are many books available for purchase today that outline a variety of research-related topics, including types of research studies, analysis and design, and other skills required to conduct research. Unfortunately, very little information is typically available that details ways to initially become involved in the research process, or paths to take once immersed. This book provides an unbiased and unintimidating overview of the career of a clinician scientist from novice to seasoned expert. The content has been selected in such a way as to be relevant to a wide range of readers.

Jennifer A. Pryor — 2009-07-23

This is an excellent, clinically orientated text that would be an invaluable companion book for physiotherapy undergraduate and postgraduate students undertaking clinical placements in respiratory care, and for clinicians working either in the respiratory area or participating in an on-call and weekend service.

Liz Jones — 2010-03-01

This is the long-awaited second edition of a popular book, the first edition of which proved to be an excellent source of information for physiotherapists, students and others working in the field of learning disability.

Margaret J. Mayston — 2010-03-01

Although this book is written for occupational therapists working primarily in the area of acquired brain injury (ABI) rehabilitation, it also provides a useful resource for physiotherapists. There is an increasing need to understand roles of the members of a multi-disciplinary team, and to develop common basic knowledge and skills to enable optimal client-centred management. This fourth edition results from an extensive update of the third edition (1996). Most topics have been expanded significantly, a comprehensive range of references and resource material is provided, and there is a new chapter on the use of technology.

Amanda Connell — 2010-03-01

This is a long-awaited book on a method of physiotherapy practice that predominates in neurological rehabilitation in Europe and is widely recognised internationally. The Bobath Concept has had a major impact on the physiotherapy profession and the clinical skills of physiotherapists. Whilst there is no doubt that this approach to neurological rehabilitation is very influential, the evidence base to explain its effectiveness is poorly researched. Unfortunately, this book does little to address the issue, either in its appraisal of current evidence or in academic discussion of gaps between clinical experience and research. The preface states that the book is written primarily for clinicians; as such, it should – but does not – incorporate the latest available evidence and research to explain practice, in line with the ethical principles of the World Confederation for Physical Therapy. It is disappointing that a book which will undoubtedly attract a large readership does not avail itself of the wealth of research to explore and explain the clinical effectiveness of this method of practice in a more balanced and academically rigorous manner.

Zara Hansen — 2010-03-01

This book was written primarily as a study aid for Open University students undertaking the first year in an undergraduate programme in Health Sciences. The authors aim to provide the reader with an understanding of pain from a psychobiological perspective. It is a well-written text that encourages self-directed learning, using questions and answers interspersed with tasks on an accompanying disk. In addition, each chapter has summary points along with learning outcomes and self-assessment questions.

Roberta Eales — 2010-03-01

A team of internationally renowned experts have contributed to produce a book that contains the detail of our current state of knowledge of pelvic floor dysfunction and the role of physiotherapy. This book aims to bridge the gap between evidence-based research and clinical practice in physiotherapy for pelvic floor dysfunction. While not actively encouraging the discontinuance of treatments that have little supporting evidence, an emphasis is placed on the stimulation of ideas and providing recommendations for further research.

Angie McManus — 2010-03-01

The information contained in this well-presented book is easily accessible. The author writes that the book is ‘designed to offer practical advice and reference material for parents, teachers, therapists and others who care for children with mild to moderate developmental delays affecting motor skills’, and it achieves this aim succinctly. It is easy to read and informative, and has a clear layout and structure. Some American phrases are used but these are easily adapted to UK terminology. The seven chapters are divided into two clear categories: ‘Understanding the Nature of Motor Skills’ and ‘Practical Strategies and Activities for Home and School’. All the chapters are clear in their content, and supplemented effectively with illustrations and information charts.

Ricky Mullis — 2010-03-01

This book provides a comprehensive guide to the background, rationale and utilisation of assessment and outcome measurement. It justifies the importance of taking a robust approach towards outcome measurement, and contains sections on validity, reliability and the often-overlooked aspect of clinical utility. Clear definitions of the concepts are given throughout, with reference to further reading where appropriate.

Lester Jones — 2010-03-01

The focus of this book is the assessment and management of craniofacial disorders for a target audience of physiotherapists and manual therapists. Readers are advised by the key author to be selective in the use of the text as the scope of the book is broad and the information quite detailed. The organisation allows the reader to find relevant information easily, but also follows a logical sequence for those who read the text from beginning to end. The use of effective figures and tables, and clear and relevant headings within the text, help with comprehension of the detailed information.

Kieran O'Sullivan — 2010-03-01

This book is successfully aimed at both the professional involved in the analysis of human movement and the general reader. The author discusses the importance of postural analysis as one dimension of musculoskeletal assessment, and suggests, controversially, that physiotherapists traditionally place less emphasis on posture than it perhaps deserves. Although not clear from the title or introduction, the text deals primarily, although not exclusively, with childhood postural disorders. The author emphasises that posture is not a ‘static independent entity’, but is part of who we are and how we move and interact with our environment, highlighting that postural correction involves far more than a list of exercises. The author does not overcomplicate the concept of ‘good’ posture, but acknowledges that posture should allow for optimal function.

Patsy Rochester — 2010-03-01

This paperback textbook is aimed primarily at specialist continence physiotherapists, continence advisors and urology nurses. The author also notes that it will be a useful source of reference for medical students, student nurses, student physiotherapists, urologists and general practitioners. The book is a follow up to Dorey's earlier textbook entitled ‘Conservative treatment of male urinary incontinence and erectile dysfunction’ .

John Stephenson — 2010-03-01

This is one of the first Pilates books to tackle the enormous task of providing a comprehensive overview and study of Pilates, including the full range of apparatus. It covers material that has only previously been available in a few professional educational programmes. The book is for professionals and serious enthusiasts who seek a deeper understanding of the Pilates method, from the muscle focus and action of the exercise to the far-reaching benefits. It guides teachers and students through the philosophy and much of the vast repertoire of the Pilates method. The author is respectful of and inspired by the original system of physical and mental conditioning developed by Joseph Hubertus Pilates. The book also succeeds in explaining the science of human movement as it relates to the Pilates method. The material is referenced both scientifically through anatomy, physiology, biomechanics and kinesiology, and artistically through aesthetics, inner sensations, psychological components and energy flow.

Fiona Jones — 2010-03-01

The author of this book is clearly an expert in the area, and writes with a convincing and compelling style in a language that is accessible for most readers, whether professionals or lay people with an interest in stroke. She uses insight and her proximity to the personal consequences of stroke in order to focus the reader on the complexities associated with the condition, but without forgetting that each patient is an individual. This approach is used to good effect to illustrate the intricate aspects of stroke through a series of cases based on real individuals.

Stephen May — 2010-03-01

This book provides guidance on becoming an evidence-based practitioner in the field of rehabilitation. It presents a detailed review of what constitutes evidence-based practice, and step-by-step guidance on searching for and assessing the evidence. This second edition has been updated with new exercises and additional chapters.

Michele Harms — 2010-03-01

Martin Bland, Professor of Statistics at St Georges Hospital Medical School, is a recognised authority in the field of medical statistics. This third edition develops ideas from earlier editions, and introduces new concepts as data analysis techniques have evolved since the second edition.

Michele Harms — 2010-03-01

This book has been edited by a team of experts with contributions from authors whose names are synonymous with medical statistics and data analysis. Many journals, including Physiotherapy, the Lancet and the BMJ, now expect scientific papers to include confidence intervals where appropriate, with less importance attached to the presentation of P-values from hypothesis testing. However, it has often been a complex task to find the appropriate method of calculating confidence intervals in every situation. This book goes some way towards addressing this. It is written in a clear and interesting style and is well referenced.

Peter Malliaras — 2010-03-01

This book aims to provide clinicians working in sport with current evidence and expert clinical knowledge relating to sport and exercise injury management. The book is directed towards an international audience and includes contributions from over 50 international authors.

Lynne Gaskell — 2010-03-01

The principal theme of this book is to provide health professionals, therapists, kinesiologists, educators, researchers and both undergraduate and postgraduate students with an understanding of the physiological mechanisms of skeletal muscle damage, repair and management.

Christine Carpenter — 2010-03-01

The aim of this book is to inform and guide physiotherapy practice in spinal cord injury (SCI) rehabilitation, and it is intended ‘for students and junior physiotherapists with little or no experience in the area of SCI’ (p. ix). The author draws effectively on important theoretical influences such as evidence-based practice, the International Classification of Functioning, Disability and Health, and motor learning and control theories. Each chapter is well referenced and the content is logically sequenced in five sections.

Jill Lorimer — 2010-03-01

This book is aimed at patients with a diagnosis of lymphoedema, providing advice on the condition and recommended treatment, thus enabling the patient to become an expert in self-management. The authors are renowned for their expertise in the field of lymphoedema therapy.

Sarah Dunbar — 2010-03-01

The focus of this book is to provide information related to acute, critically ill stroke diagnosis and management. Designed as a reference text for professionals, it is primarily intended for medical staff, and presents information about medical management and diagnostic testing. It is successful in providing detailed information in a concise form. The editors are American and consequently some of the procedures, particularly in the initial stages of stroke management, do not translate directly to UK work practices. For physiotherapists, it would potentially be appropriate as a reference text within an acute stroke ward. However, possibly as a result of multiple authorship, the text alternates between basic information and in-depth, highly detailed technical information.

Heather Thornton — 2010-03-01

The publication of a book as part of a series on management for allied health professionals (AHPs) is a positive move. Although primarily aimed at AHPs, many of the chapters are generic and so could be useful to any healthcare worker. However, some chapters fail to address the specific issues faced by AHPs; for instance, Chapter 4 is largely theoretical with limited application, and the discussion on the regulation of doctors in Chapter 1 is three times the length of that of non-medical healthcare professions. However, other chapters are strongly supported by case studies (Chapters 2 and 11) and relevant examples (Chapter 3).

Pete Gladwell — 2010-03-01

This text will be a valuable resource for physiotherapists in many settings working with patients who experience pain. It certainly has a place on the bookshelf of outpatient physiotherapy departments and occupational health departments, and on the reading list for undergraduate physiotherapy courses. It is a significant refocusing of the first edition, published in 2000, which was written primarily for therapists involved in pain management programmes, and it is still an excellent text for these clinicians. This second edition offers an accessible structure, divided into six sections: Models and mechanisms, Assessment, Psychosocial interventions, Tertiary pain management programmes, Occupational perspectives, and a concluding section. It is thoroughly referenced, and the references will act as signposts into the relevant literature for those who wish to explore issues further. It includes recent theory, but also introduces a historical perspective where appropriate, such as the history of pain theories. Whilst some psychological approaches to pain seem to reinforce a dualistic, mind and body approach, this book ensures that a united approach is taken: ‘the multidimensional framework offered by the biopsychosocial model has required the integration of psychological concepts with both biomedical and socio-economic perspectives’ (p. 51). There is a clear explanation of the evidence on risk and prognosis, using the Flag concept to focus upon the specific factors which might lead the therapist in the direction of a particular treatment strategy. Following on from the assessment section, a thorough explanation of a cognitive behavioural approach to the management of pain includes consideration of the broad range of issues to be considered in developing a successful treatment package. The book is well organised and thoroughly indexed, allowing the reader to dip into a section or to search the book for specific information.

Rhonda J. Scudds — 2008-11-17

This is an excellent book which aims to examine all the facets of pain from the basic science aspects to the biopyschosocial model. It is intended for all medical and paramedical readers, and does not assume much previous knowledge of pain. To a certain extent, it achieves its goal as it covers the range of topics that might be expected to be found in any modern pain curriculum. However, it seems to be more aimed at the medical model of pain, which is understandable as 13 of the 20 authors are anaesthesiologists. Although there are sections on the physiotherapy management of pain, none of these sections are authored by physiotherapists. Interestingly, there is not a single reference to occupational therapy. There is one well written chapter by a psychologist.

Anne V. O’Brien — 2008-11-06

This pocket-sized paperback book is primarily aimed at educated patients and their carers. Whilst generally written in lay language, the level of detail offered would be informative for, and possibly more appropriate for, junior health professionals unfamiliar with this auto-immune disorder. Tables provide useful summary information, but most contain medical terminology unfamiliar to the lay reader.

J. Bott — 2009-01-20

Having trained in the Buteyko method with the authors, this was an interesting pack (DVD, handbook and CD) to review. It is designed to teach both individual patients and healthcare professionals how to perform the Buteyko method. Techniques are clearly and simply described, and are similar to those used in the conventional method of physiotherapy for control of asthma symptoms and hyperventilation (reduced breathing and relaxation techniques) . It would be useful for physiotherapy departments and university libraries to hold as it is very relevant to physiotherapy. All respiratory physiotherapists should be aware of this method; those trained in the conventional method will achieve similar results to the Buteyko method , and can use their clinical judgement on whether all, or any specific, components should be used or included in their patient management.

Andrea Selley — 2009-01-20

‘Physiotherapy for Children’ is edited by Teresa Pountney with chapters written by a team of experienced practitioners. The book comprehensively covers a range of paediatric conditions experienced by both children in the mainstream and those with long-term disability or disease.

Jackie Hammerton — 2009-01-05

This hardback volume fulfils the aim of providing the reader with a comprehensive theoretical, clinical and evidence-based resource. The book is targeted at health professionals involved in the diagnosis and management of patients with Parkinson's disease, best suiting individuals with some previous experience. The editors are all clinicians from the USA and the book is written from their healthcare perspective; however, this does not detract from its value to UK health professionals.